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Cystitis and other urinary tract infections (UTIs) in women of reproductive age can lead to infertility, significantly complicate the course of pregnancy, and cause numerous fetal abnormalities. Antibiotic therapy during pregnancy is an extreme measure since it is associated with a high risk of fetal malformations. The use of D-mannose is an effect...
Citations
Antibiotics are most often used to combat urinary tract infections (UTIs). Taking into account the side effects related to antibiotic therapy, existing antibiotic-resistant strains of uropathogens, as well as the low effectiveness of the vast majority of antibiotics against bacterial agglomerations (biofilms), a search for alternative approaches to treat UTIs is highly relevant. One of the important in such search is presented by use of nutraceuticals – D-mannose (prevents interaction between pathogenic E. coli strains and the urothelium, destroys bacterial biofilms), Lactobacilli (prevents formation of bacterial pathogen biofilms, normalizes human microbiome, alleviates inflammation) and standardized cranberry extracts (inhibits uropathogen adhesion, exerts anti-inflammatory action). The results from basic and clinical studies suggest not only about high safety of such pharmaconutraceutical support of UTIs therapy, but also the effectiveness of separate and combined use of such nutraceuticals comparable to that of antibiotics, especially in treatment of uncomplicated UTIs forms
Key content
Stress urinary incontinence is common in pregnancy and its severity can be reduced with pelvic floor muscle training.
Overactive bladder syndrome prevalence increases with gestation and treatment can be conservative or medical.
Pelvic organ prolapse is multifactorial. Pelvic floor exercises and pessaries are important treatments and previous surgical management can affect the mode of delivery.
Recurrent urinary tract infections can be treated with antibiotic prophylaxis or with non‐antibiotic prophylaxis such as methanamine hippurate, D ‐Mannose and hygiene behaviour.
Urinary retention can occur at any point during pregnancy, causing bladder distension, voiding dysfunction and subsequent lifelong catheterisation.
Learning objectives
To be aware of the pathophysiology and management of different types of urinary tract dysfunction in pregnancy and the postpartum period.
To understand the potential causes and management of pelvic organ prolapse in pregnancy and the postpartum period.
To understand the different potential management options in recurrent lower urinary tract infections.
Introduction . Chondroitin sulfate (CS) and glucosamine sulfate (GS), widely used as chondroprotectors, can maintain the normal functioning of the urinary system but their effect has not been analyzed systematically.
Aim : to perform a systematic analysis of the possibilities of using CS and GS in patients with pathology of the kidneys and urinary system.
Materials and methods . Predictive analysis of 2,093 publications on the interactions of CS/GS with the functioning of the kidneys and other organs of the urinary system found at the request “(urinary OR bladder OR kidney) AND (glucosamine OR chondroitin)” by methods of the theory of topological data analysis.
Results . Disorders of cholesterol and glucosamine metabolism are characteristic of cystitis, glomerular nephritis, urinary tract infections (UTIs), urolithiasis, proteinuria, and formation of diabetic nephropathy. In addition to inhibiting the pro-inflammatory cascade NF-kB, CS/GS contribute to eliminating the deficiency of glycosaminoglycans in the pathology of urothelium, inhibit urolithiasis, inhibit the synthesis of pro-inflammatory nitric oxide NO in macrophages, and modulate O-glycosylation processes.
Conclusion . The results of fundamental and clinical studies show that subsidies of CS/GS substances of pharmacological quality per os and CS instillation in the bladder (in particular, in combination with hyaluronic acid) are the means of choice for patients suffering from osteoarthritis and diseases of the urinary system. Highly purified pharmacological CS substances are part of the preparation Chondroguard.
